Torsion of ovarian cyst presenting as acute abdomen: A prospective study
Shabir Ahmad Mir, Hanief Mohamed Dar, Waseem Ahmad Dar, Mumtazdin Wani, Omar Shah
Background: Ovarian torsion present as acute abdomen in emergency department. Torsion of ovarian cyst remains a diagnostic challenge. Torsion of ovarian cyst is a rare condition; hence its diagnosis needs high index of suspicion. Ovarian salvage rate is low in our setup till now. Aim: To define the various factors helpful in limiting the prolonged delay before surgical intervention to improve ovarian salvage rate. Material and Methods: This prospective study was conducted in Shri Maharaja Hari Singh (SMHS) Hospital, an associated hospital of Government Medical College Srinagar in department of general surgery over a period of 5.5 years from July 2012 to December 2017 (5.5 years). Patients were evaluated in the emergency department by history, clinical examination, baseline blood investigations, ultrasonography/doppler sonography. CT (Computed Tomography) was done only in selected patients. In this study, only those subjects were finally included in whom the diagnosis of ovarian cyst with torsion was confirmed intra-operatively. Results: During the study period of 5.5 years, 31 patients with torsion of ovarian cyst were included after being diagnosed during surgical exploration. Age of the patients ranged from 26 to 57 years with the mean age of 37.61± 6.96(SD=6.96). Salvage of the ovary was done only in 3 patients while in others ovary was sacrificed because of delayed definitive diagnosis. Conclusion: Torsion of ovarian cyst remains a diagnostic challenge. Torsion of ovarian cyst is a rare condition; hence its diagnosis needs high index of suspicion. Clinical features, history of ovarian cyst, and ultrasonography/ doppler ultrasonography should all be used to help in early diagnosis of this condition. Early diagnosis is needed to improve the ovarian salvage rate. Surgery provides definitive diagnosis and management of torsion ovarian cyst, hence unnecessary delay should be avoided.